Warm-water footbath improves dysmenorrhoea and heart rate variability in college students: a randomised controlled trial

Abstract

The effect of warm-water footbath in improving dysmenorrhoea has been rarely investigated. The study aimed to examine whether a warm-water footbath effectively reduces dysmenorrhoea pain and improves the autonomic nervous system (ANS) activity. The randomised controlled trial was registered at ClinicalTrials.gov. (NCT04071028) We enrolled college students with dysmenorrhoea in Northern Taiwan from December 1 2013 to June 30 2014, and randomised them into footbath (n = 35, median age 19 years) and control groups (n = 33, 18 years). Pain visual analogue scale and Short-Form McGill Pain Questionnaire were used for pain assessment, while heart rate variability (HRV) was measured to assess ANS function. After the interventions, the footbath group significantly improved ANS activity and reduced pain severity comparing to the control group. Furthermore, the changes in HRV positively correlated with the improvement of pain severity. In conclusion, a warm-water footbath is beneficial in improving the pain severity among college students with dysmenorrhoea.

Impact Statement

• What is already known on this subject? Dysmenorrhoea is the most common gynaecological condition affecting 34–94% of young women. The existing conventional therapeutic strategies for dysmenorrhoea have potential adverse events. Among the complementary therapies for pain, the warm-water footbath is a widely used thermal therapy in improving peripheral neuropathy symptoms and improving patients’ quality of life. The subjects with dysmenorrhoea associate with significantly altered autonomic nervous system (ANS) activity. However, the association among warm-water footbath, menstrual pain and ANS was rarely investigated previously.

• What the results of this study add? The randomised controlled trial enrolling 68 college students with dysmenorrhoea found warm-water footbath improved ANS activity and reduced pain severity. Furthermore, the changes in heart rate variability positively correlated with pain severity improvement.

• What the implications are of these findings for clinical practice and/or further research? A warm-water footbath for 20 minutes on menstruation days 1 and 2 is beneficial in improving pain among college students with dysmenorrhoea.

Keywords:

• Footbath
• Short-Form McGill Pain Questionnaire
• pain visual analogue scale
• parasympathetic activity
• dysmenorrhoea
• sympathetic activity

Acknowledgements

The authors thank Simone Yu for the professional English-editing.

Author contributions

S.J.W.: Conceptualisation, Data curation, Formal analysis, Funding acquisition, Investigation, Methodology, Resources, Software, Validation, Writing – original draft

W.C.K.: Formal analysis, Investigation, Methodology, Software, Supervision, Validation, Writing – review & editing.

C.C.S.: Conceptualisation, Data curation, Formal analysis, Investigation, Methodology, Resources, Supervision, Validation, Visualisation, Writing – review & editing.

Disclosure statement

The authors stated that they have no conflict of interest.

Additional information

Funding

The research was supported by Saint Mary's Hospital Research Fund under Grant [SMHRF102007]. The funders had no role in study design, data collection, and analysis, decision to publish, or preparation of the manuscript.